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ESMO 2019: Does Olaparib Benefit Men With Advanced Castration-Resistant Prostate Cancer?

By: Cordi Craig
Posted: Monday, October 7, 2019

According to results of the phase III PROfound trial, the PARP inhibitor olaparib performed better than newer hormonal therapies, enzalutamide and abiraterone, in terms of progression-free survival and overall response rates among men with metastatic castration-resistant prostate cancer with homologous recombination repair (HRR) gene alterations. This study was presented at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona (Abstract LBA12_PR) and published in the Annals of Oncology.

“Our results show the potential of a genetically targeted treatment for patients with advanced disease. I am confident we are now entering a new era of personalized care and precision medicine for metastatic prostate cancer,” stated co-principal investigator Maha Hussain, MD, of Northwestern University Feinberg School of Medicine, Chicago, in a Northwestern Medicine press release.

Of the 4,425 men screened for HRR gene alterations, 245 were included in cohort A, comprising patients with alterations in BRCA1, BRCA2, or ATM. Cohort B included 142 patients with alterations in any of the 12 other HRR genes, including BRIP1, BARD1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, or RAD54L. In each cohort, patients were randomly assigned 2:1 to receive olaparib or physician’s choice of enzalutamide or abiraterone.

In cohort A, radiographic progression-free survival was 5.82 months in men treated with olaparib versus 3.52 months among those treated with hormonal therapy (P < .001); also in cohort A, the median overall survival at the interim analysis was 18.5 months with olaparib compared with 15.1 months with hormonal therapy. In addition, 12-month progression-free survival rates were 22.1% and 13.5% for olaparib versus hormonal therapy, respectively. The overall response rates also improved among patients in cohort A (21.7% vs. 4.5%). The safety results were consistent with the known profile of olaparib.

Disclosure: The study authors’ disclosure information may be found at cslide.ctimeetingtech.com.



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